放疗联合EGFR-TKI靶向治疗对Ⅳ期非小细胞肺癌患者血清肿瘤标记物及疗效的影响

Effect of Rdiotherapy combined with EGFR-TKI Targeting Therapy on Serum Tumor Markers and Therapeutic Effect in Patients with Stage Ⅳ Non-small Cell Lung Cancer

目的: 探究放疗联合表皮生长因子受体酪氨酸激酶抑制剂(EGFR-TKI)靶向治疗Ⅳ期非小细胞肺癌(NSCLC)血清肿瘤标记物及治疗效果。 方法: 回顾性的选取2017年10月至2018年9月我院收治的92例Ⅳ期NSCLC患者作为研究对象,以治疗方法分为两组,每组各46例,接受单纯放疗记为放疗组,放疗联合EGFR-TKI治疗记为联合组;比较两组患者临床疗效、血清生化指标、免疫功能及毒副作用。 结果: 联合组总有效为82.61%,显著高于放疗组的54.35%(χ 2=8.51,P<0.05)。组内比较,两组患者在治疗后血清生化指标血管内皮生长因子(VEGF)、血清癌胚抗原(CEA)、血清糖类抗原(CA125)、基质金属蛋白酶9(MMP9)以及细胞角质蛋白19片段抗原21-1(CYFRA21-1)水平均显著下降(均P<0.05);治疗后组间比较,联合组各生化指标均显著低于放疗组(P<0.05)。治疗后免疫功能比较,联合组CD4+、自然杀伤细胞(NK)水平均显著高于放疗组(P<0.05),而CD8+水平显著低于放疗组(P<0.05)。 结论: 放疗联合EGFR-TKI可提高临床治疗效果,有效控制肿瘤进展、提高免疫功能,而提供较好的内环境,且不会增加毒副作用。

Objective: To explore the radiotherapy combined EGFR - TKI targeted therapy Ⅳ NSCLC serum tumor markers and therapeutic effect. Methods: From October 2017 to September 2018, 92 patients with stage Ⅳ NSCLC in our hospital were selected as the research objects. The treatment methods were divided into two groups, 46 cases in each group. The patients in each group were treated with radiotherapy alone and EGFR-TKI as the combined group. The clinical efficacy, serum biochemical indicators, immune function and toxic and side effects of the two groups were compared. Results: The total effective rate was 82.61% in the combined group, significantly higher than 54.35% in the radiotherapy group (χ 2=8.51,P<0.05). Compared within the group, serum biochemical indexes of VEGF, CEA, CA125, MMP9 and CYFRA21-1 in the two groups were significantly decreased after treatment (all P<0.05). After treatment, all biochemical indexes in the combined group were significantly lower than those in the radiotherapy group (P<0.05). Immune function after treatment compared, CD4+ and NK level joint group were significantly higher than in radiotherapy group (P<0.05). The CD8+ level was significantly lower than that of the radiotherapy group (P<0.05). Conclusion: Radiotherapy combined with EGFR-TKI can improve the clinical therapeutic effect, effectively control tumor progression, improve immune function, and provide a better internal environment without increasing toxic and side effects.